How a NYC Speech Therapist Uses Neuro-Affirming Care to Improve Communication Confidence in Selectively Mute Children

Johnny’s mom was shocked when she learned during the first parent teacher conference night of the third grade that Johnny was not talking during the school day.

Johnny was not talking in class.

Johnny was not talking in the lunchroom.

Johnny was not even talking on the playground.

Nope. Not a single word.

He was completely silent throughout the entire school day.

Mom was very surprised!

In fact, she almost fell off her chair!

Johnny was extremely verbal at home.

Johnny loved telling his mom and little brother about his school day adventure when he came home each afternoon.

He frequently enacted his favorite scenes from K Pop Demon Hunters while singing loudly and confidently for his whole family to hear!

Mom questioned the teacher for details.

“What do you mean Johnny is not speaking in class”

“I’m so confused because he is a complete chatterbox and drama king at home”

That’s when his teacher suggested they visit a speech-language pathologist for evaluation to figure out what was going on because he was not uttering a single word at school.

And that’s when mom called me.

I came aboard to help support this highly intelligent and sensitive little boy.

Our goals were for him to communicate confidently in his home, school and community.

Johnny came in for an initial speech consultation with me.

I could hear him laughing and talking with mom in the waiting room as he read the books in my waiting room.

However the moment –

I opened the door and invited him into my playspace – he completely froze and went silent.

You could hear a pin drop.

I already had a feeling from the conversation with mom on the phone that Johnny could be showing characteristics of a communication difference called selective mutism.

What is Selective Mutism (SM)?:

Selective mutism is usually rooted in and perpetuated by anxiety loops around verbal and social communication behaviors required outside of the home.

A child’s ability to speak comfortably and easily at home is marked in contrast to the child’s minimal verbal output shown in certain social settings like at school or community gatherings.

What Causes Selective Mutism?

There is no singular cause of selective mutism.

Selective Mutism is considered a type of social anxiety that a child experiences when needing to communicate outside of the home.

Selective Mutism is a difference which can surface from a multitude of factors.

These factors can include:

Shyness and introverted nature
Social anxiety

A present of expressive and/or receptive language differences
A response to a traumatic event or series of extremely stressful events

According to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, in order to be diagnosed with selective mutism, an individual must meet the following criteria:

Absence of speaking in a social situation – in contrast to speaking often at home.
This lack of speaking negatively affects the child’s educational success and social development with peers.
The lack of speaking is beyond a limited timeframe – lasting over 4-6 weeks time and consistently noticed within outside environments as compared to the child’s home environment.
This lack of speech cannot be attributed to a lack of language required for social and educational participation.
The disturbance is not better explained by a communication difference and does not occur exclusively due to another neurodevelopmental psychiatric or cognitive difference.

It is important to note that research has shown that children with a history of speech and language differences may be at a higher risk for developing selective mutism as a secondary and compensatory strategy to speaking and learning challenges.

This is one of the many reasons early and effective speech and language therapy is optimal for a child that is struggling to acquire the key developmental milestones.

How Does Selective Mutism Affect a Child’s Every Day Life?

Selective mutism commonly co-occurs with other forms of social anxiety.

A child who is diagnosed or suspected of having a communication difference like Selective Mutism can be deeply affected on a daily basis by their inability to speak in group settings.

This inability to speak in a group and unfamiliar setting can have a cascade of effects on the child’s development and inner wellbeing, sense of self and confidence.

A Selectively Mute child may experience:

Difficulty participating in the classroom

Forming meaningful friendships with peers

Engaging in play dates and after school activities with peers

How Can A Neuro-Affriming Speech Therapist Help a Child with Selective Mutism?

A speech-language pathologist may work closely with a psychologist, or neuropsychologist to diagnose and treat a child with selective mutism.

A Selectively Mute diagnosis can only be made by an experienced speech therapist or psychologist.

There is no singular cause of selective mutism.

It is a type of anxiety that presents itself during periods of social stressors.

A child who is selectively mute may appear shy around others and experience anxiety during social situations.

Children with Selective Mutism may actively avoid speaking situations.

Over time this feedback loop becomes reinforcing for the child’s nervous system.

It is also important to note that untreated expressive and receptive language concerns can lead to an increased risk of developing selective mutism – as the child becomes frustrated and disengages with the outside.

What Does Neuro-Affirming Care Look Like in the Treatment of Selective Mutism:

Chatty Child’s treatment and care for a child with Selective Mutism is rooted in the principles of neuro-affirming and trauma-informed care.

My initial goals for a child with Selective Mutism are foundational and include:

Building a feeling of complete safety and trust.
Developing rapport and trust with the child.
Engaging in Nervous System Regulation Activities
Finding out what interests and excites them.
Learning about their likes and dislikes.
Creating a space of trust, safety and belonging
Creating spaces and activities for them that feel safe, calm, regulating and secure.

These foundational steps should not be skipped.

These foundational pieces may even take some time to foster and build and they are crucial for your child’s communication success and confidence.

Once those foundational elements of trust and safety have been built and secured only then can we move to the next phase of treatment.

This next phase includes slowly building a child’s tolerance for speaking to others through the use of:

— pretend role playing games

— turn taking during cooperative games

— art making processes

— dramatic story telling

— Sensory play

— Imaginative and immersive exploration

and so much more!

Remember folks – always focus on building connection and trust with your child first and foremost!

Please encourage, validate and accept ALL communication forms

ALL communication starts with regulation and connection FIRST!

Reach out for support – we are here to help your child become a confident communicator.

Sincerely,
Heather Lynn Boerner, MA CCC/SLP

Is your child extremely shy? Do they shut down verbally in social or academic contexts? Chatty Child’s creative speech therapists are here to support and guide you.

Chatty Child’s expert speech and language therapy may be the missing piece to the puzzle!

Working with a speech-language pathologist could be the support you’ve been looking for – don’t hesitate to reach out to your experienced team of speech-language pathologists who can help create a tailored made program for your neuro-diverse learner.

We offer personalized neurodivergent affirming, speech, language, feeding and occupational therapy therapy, as well as creative mindfulness classes for all ages and abilities.

In person and online options are available for all therapeutic sessions and classes.

Our speech and occupational therapists are here to support all your child’s therapeutic needs.

I invite you to schedule a tour – to discover the support waiting for your child – at Chatty Child.

We are here to help and support your child – grow and learn!

Let’s create excellent communicators, confident voices, calm minds, and limitless possibilities – together!

Begin Children’s Speech and Occupational Therapy for Learning Success:

At Chatty Child, we believe every child deserves to feel capable, confident at school, at home, and in the community. If your child is struggling here is how to get started:

Contact us or call 347.491.4451 for a free 15-minute conversation to discuss the classroom challenges your child is facing and how speech therapy can help.
Schedule a comprehensive evaluation that may include school observations to understand your child’s needs in their actual learning environment.
Begin individualized therapy sessions with goals focused on the skills that support classroom success—from auditory processing to executive functioning to speaking confidence.
Collaborate with your child’s therapeutic team through regular communication, team meetings, and shared strategies that create consistency across home and school.

Your child doesn’t need to struggle alone. With the right support, they can build the communication skills and confidence that makes learning joyful, friendships easier, and confidence possible.

Holistic Speech, Feeding & Occupational Therapy Services for Children in NYC

At Chatty Child, we support children as they develop the communication, cognitive, and social-emotional skills that help them thrive at home, in school, and in their community. Our approach looks at the whole child, recognizing that language development is deeply connected to learning, relationships, and self-confidence.

Our services include:

Speech Therapy – Individualized, play-based support for language development, speech clarity, social communication, and everyday confidence.
InterAct – A storytelling and play-centered program that strengthens language, imagination, and connection through shared narrative experiences.
Mindfulness classes for all ages – support for emotional, sensory and self regulation, curated classes using mindfulness and meditation practices
Occupational Therapy – Support for sensory processing, motor development, and independence in daily routines and self-care skills.
hum studios – Mindfulness and compassion-based classes that foster emotional awareness, regulation, and accessibility for children of all ages.
Teletherapy – Flexible virtual speech and occupational therapy services available throughout New York State.
Tutoring – Personalized academic support focused on reading, writing, comprehension, and critical thinking skills.
Functional Nutrition – Developmental support strategies that use nutrition-informed approaches to support regulation, attention, and overall well-being.
Consulting – Collaborative guidance for parents, caregivers, and educators to support consistency across home, school, and community environments.
Group Programs – Small-group sessions that build communication, social interaction, and emotional skills through guided peer engagement.

Meet Heather Boerner, Trusted Pediatric Speech-Language Pathologist & Feeding Specialist in NYC

Heather Boerner, MA, CCC-SLP, is a licensed, nationally certified speech-language pathologist with over 23 years of experience supporting children through pediatric speech therapy in NYC. Her clinical work is shaped by training in mindfulness, a trauma-informed perspective, and her lived experience as a neurodiverse, differently-abled individual. These elements inform her deeply responsive, whole-child and neuro-affirming approaches to care.

Motivated by her personal journey, Heather founded Chatty Child Speech, Occupational & Physical Therapy, PLLC. The practice is built on creativity, collaboration, and individualized support. She works closely with schools through classroom observations and team meetings to ensure children receive consistent, coordinated care. Heather is also the author of Carrie the Colorful Chameleon, a children’s book created to encourage confidence, curiosity, and connection.

Heather and her team offer in-person therapy at the Tribeca clinic and virtual services throughout New York State. Together, they help children build the communication skills, confidence, and self-advocacy abilities they need to thrive in school and beyond.

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By accessing this website, Creating Voices blog and all related content you are agreeing to these terms and conditions of use. The contents in this medical disclaimer and terms of use can be modified or changed at any time. Chatty Child assumes no obligation to correct or update the website nor to resolve or clarify any inconsistent information that might be a part of the website. The information contained in this Chatty Child website and Creating Voices blog are for general and informal purposes only. Information discussed on this website and blog are not intended to and should not be used as substitute for medical or therapeutic advice, diagnosis or treatment. This website and blog does not constitute in any way a therapeutic relationship. Please contact our office or email us to be evaluated at our clinic for specific concerns or questions. All contents in this website and blog are for informal purposes only and copyrighted and created by Heather Lynn Boerner MA CCC/SLP © 2026 – all rights reserved. Written permission to copy and distribute any content is required

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